The impact of frailty on admission to home care services and nursing homes: eight-year follow-up of a community-dwelling, older adult, Spanish cohort

Abstract

Background: Frailty in older adults is a common multidimensional clinical entity, a state of vulnerability to stressors that increases the risk of adverse outcomes such as functional decline, institutionalization or death. The aim of this study is to identify the factors that anticipate the future inclusion of community-dwelling individuals aged ≥70 years in home care programmes (HC) and nursing homes (NH), and to develop the corresponding prediction models. Methods: A prospective cohort study was conducted in 23 primary healthcare centers located in Catalonia, Spain, with an eight-year follow-up (2005-2013). The cohort was made up of 616 individuals. Data collection included a baseline multidimensional assessment carried out by primary health care professionals. Outcome variables were collected during follow-up by consulting electronic healthcare records, and the Central Registry of Catalonia for mortality. A prognostic index for a HC and NH at 8 years was estimated for each patient. Death prior to these events was considered a competing risk event, and Fine-Gray regression models were used. Results: At baseline, mean age was 76.4 years and 55.5% were women. During follow-up, 19.2% entered a HC program, 8.2% a NH, and 15.4% died without presenting an event. Of those who entered a NH, 31.5% had previously been in a HC program. Multivariate models for a HC and NH showed that the risk of a HC entry was associated with older age, dependence on the Instrumental Activities of Daily Living, and slow gait measured by Timed-up-and-go test. An increased risk of being admitted to a NH was associated with older age, dependence on the Instrumental Activities of Daily Living, number of prescriptions, and the presence of social risk.

Predictors of Nursing Home Admission in the Older Population in Belgium

“…The incidence of NHA may be in uenced by organizational aspects and the cultural aspects [47], but also by the availability, accessibility and affordability of home care facilities. The characteristics of the study population also play a role since the cumulative incidence of NHA could be affected by the higher risk of death in the population under study.…”

Digital Biomarker Representing Frailty Phenotypes: The Use of Machine Learning and Sensor-Based Sit-to-Stand Test

“…The 5×STS is an important component of the Short Physical Performance Battery, a clinical tool used for identifying physical frailty [ 32 ]. Therefore, sensor-based 5×STS could enable health professionals to quickly identify slowness, weakness, and exhaustion, which can assist in recognizing potential modifiable risk factors to improve health outcomes and strategies for older adults [ 33 , 34 ].…”

Is High-Speed Resistance Training an Efficient and Feasible Exercise Strategy for Frail Nursing Home Residents?

“…36e40 Moreover, low educational level is frequently noted in people admitted to nursing homes. 41,42 Of note, a recent pilot study reported that frail institutionalized older adults showed reduced episodic memory after a unique session of HSRT. 43 When these data are interpreted in light of our case study, they suggest that HSRT might be a cognitively demanding task to frail nursing home residents, specifically for those untrained.…”